| NPI | 1962466706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LYNN FAISON Chief Operations Officer 804-553-3249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: VA 160) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: VA 160) |
| 101YM0800X Counselor, Mental Health (Licence: VA 160) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-08-22 |